FDA must act on sugar, salt

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BOSTON PUBLIC Health Commissioner Barbara Ferrer knows that signing a petition to the Food and Drug Administration to regulate sugar in soda is like taking the first step up Mount Everest. Few federal agencies move with the sloth of the FDA, and few move so slowly only to do so little.

“We’re doing everything we can at the local level to combat obesity,” Ferrer said in an interview last week. “But you can do only so much when companies spend billions advertising unhealthy products. It’s been frustrating that there has not been a lot of action at the federal level to clearly state what is safe to consume.’’

We will know by summer if the FDA takes up the issue. Ferrer and other commissioners of public health, as well as a host of nutrition researchers and pediatricians, recently signed a petition organized by the Center for Science in the Public Interest, the consumer advocacy group. The petition asks the FDA to rule on what level of sugar is safe to drink and establish limits on it. (Disclaimer: My wife is a colleague of several of the petition signers from the Harvard School of Public Health. I did not consult with them in preparation of this column.)

The FDA said in an e-mail that it would respond within 180 days. The average American consumes 18 to 23 teaspoons, or 300 to 400 calories of added sugars a day. The American Heart Association recommends no more than 6 teaspoons a day for women and 9 for men.

A national safe standard on sugar content could end the contentious checkerboard of anti-obesity efforts by cities and states, such as New York City’s attempt to slash the size of sodas and the proposal by Cambridge Mayor Henrietta Davis to follow suit. A standard could render soda tax proposals needless. It could reduce confusion at vending machines and convenience stores when people reach for so-called “sports” drinks, thinking they are healthier than soda, when they often are not.

Ferrer said, “This is not a nanny state solution. It is not a nanny state when there are rules to protect against botulism, or E. coli in meat processing plants. We’re not telling the FDA to tell people what they should drink, but we are asking the FDA to make sure that what people drink is not dangerous in large quantities.”

The question
is whether the agency can find the backbone to withstand industry lobbying for the most lenient interpretations of what is safe. For instance, take sodium. Five years ago, Congress asked the Institute of Medicine to recommend healthy levels of sodium intake; the average American male consumes nearly twice as much salt a day as necessary.

In 2010, the Institute of Medicine recommended that the FDA issue mandatory standards for sodium content in food products. A year ago, the American Heart Association wrote the FDA and the Department of Agriculture to remind them that sodium consumption at safe levels should result in between 44,000 and 92,000 fewer heart-disease-related deaths a year.

Three years later, the sodium issue remains unresolved, which is almost unconscionable given the potential life savings.

Last week in another e-mail, the FDA said it is continuing to talk with “industry and other stakeholders” about the possibility of issuing “voluntary targets for sodium reduction in foods.”

That is not good enough. Michael Jacobson of the Center for Science in the Public Interest was hoping that a second-term Obama administration might be more free to listen more to “other stakeholders” than industry. “It would be nice to know that the watchdog is awake,” Jacobson said.

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